定义和研究职业性哮喘：一种共识方法。
Defining and investigating occupational asthma: a consensus approach.
作者信息
Francis H C, Prys-Picard C O, Fishwick D, Stenton C, Burge P S, Bradshaw L M, Ayres J G, Campbell S M, Niven R McL
机构信息
North West Lung Research Centre, Wythenshawe Hospital, Manchester, UK.
出版信息
Occup Environ Med. 2007 Jun;64(6):361-5. doi: 10.1136/oem.2006.028902. Epub 2006 Nov 27.
BACKGROUND
At present there is no internationally agreed definition of occupational asthma and there is a lack of guidance regarding the resources that should be readily available to physicians running specialist occupational asthma services.
AIMS
To agree a working definition of occupational asthma and to develop a framework of resources necessary to run a specialist occupational asthma clinic.
METHOD
A modified RAND appropriateness method was used to gain a consensus of opinion from an expert panel of clinicians running specialist occupational asthma clinics in the UK.
RESULTS
Consensus was reached over 10 terms defining occupational asthma including: occupational asthma is defined as asthma induced by exposure in the working environment to airborne dusts vapours or fumes, with or without pre-existing asthma; occupational asthma encompasses the terms "sensitiser-induced asthma" and "acute irritant-induced asthma" (reactive airways dysfunction syndrome (RADS)); acute irritant-induced asthma is a type of occupational asthma where there is no latency and no immunological sensitisation and should only be used when a single high exposure has occurred; and the term "work-related asthma" can be used to include occupational asthma, acute irritant-induced asthma (RADS) and aggravation of pre-existing asthma. Disagreement arose on whether low dose irritant-induced asthma existed, but the panel agreed that if it did exist they would include it in the definition of "work-related asthma". The panel agreed on a set of 18 resources which should be available to a specialist occupational asthma service. These included pre-bronchodilator FEV1 and FVC (% predicted); peak flow monitoring (and plotting of results, OASYS II analysis); non-specific provocation challenge in the laboratory and specific IgE to a wide variety of occupational agents.
CONCLUSION
It is hoped that the outcome of this process will improve uniformity of definition and investigation of occupational asthma across the UK.
背景
目前，职业性哮喘尚无国际公认的定义，且对于经营专科职业性哮喘服务的医生应随时可用的资源缺乏指导。
目的
商定职业性哮喘的实用定义，并制定运营专科职业性哮喘诊所所需的资源框架。
方法
采用改良的兰德适宜性方法，以获得英国经营专科职业性哮喘诊所的临床医生专家小组的意见共识。
结果
就定义职业性哮喘的10个术语达成了共识，包括：职业性哮喘定义为在工作环境中接触空气传播的粉尘、蒸气或烟雾诱发的哮喘，无论是否有既往哮喘病史；职业性哮喘涵盖“致敏剂诱发哮喘”和“急性刺激性诱发哮喘”（反应性气道功能障碍综合征（RADS））；急性刺激性诱发哮喘是一种职业性哮喘，无潜伏期且无免疫致敏，仅在单次高暴露发生时使用；“工作相关哮喘”一词可用于包括职业性哮喘、急性刺激性诱发哮喘（RADS）以及既往哮喘的加重。对于低剂量刺激性诱发哮喘是否存在存在分歧，但专家小组一致认为，如果确实存在，他们将把它纳入“工作相关哮喘”的定义。专家小组就专科职业性哮喘服务应具备的18种资源达成了一致。这些资源包括支气管扩张剂前FEV1和FVC（预测值百分比）；峰值流量监测（以及结果绘图、OASYS II分析）；实验室非特异性激发试验以及针对多种职业性因素的特异性IgE检测。
结论
希望这一过程的结果将提高英国职业性哮喘定义和调查的一致性。
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